Sedimentation velocity separation: a preparation method for cervical samples.

A preparation procedure, aiming at monolayer deposition of cervical exfoliative material on glass slides for high resolution prescreening has been developed. The main features of this procedure are centrifugal deposition after suspension and sedimentation of samples over isopycnic medium of 1.026 density. Fractioning of the separation column after centrifugation at 50 X g yields two preparations with leukocytes, bacteria and cellular debris predominantly located on the first slide and epithelial cells on the second one. The degree of spatial cellular isolation as well as the amount of diagnostically relevant cells per slide seem to fit the requirements of automated high resolution analysis.     

The preparation of cervical scrape material for automated cytology using gallocyanin chrome-alum stain.

A method is described for preparing cervical scrape specimens for automated analysis on the Cerviscan prescreening system. In order to reduce the cellular clumping found in cervical scrape material, cells are collected in suspension, syringed to disaggregate the cell clumps, and then pipetted onto a glass to give a monolayer of cells. The cells are then stained with gallocyanin chrome-alum to give the required quantitation of nucleic acid content, using a rapid staining procedure. Experimental results are given which show that specimens prepared by this method are more suitable for automated analysis than the conventional Papanicolaou stained preparation.     

Cytopress: automated slide preparation of cytologic material from suspension

This paper describes a new automated system to prepare slides of cytological material from suspension. The system collects material on a filter tape by filtration and transfers it to glass slides by means of pressure-fixation. Using cervical cells as a model, results show that a well-defined cell number is evenly deposited over a standardized area, while a small number of cells is retained on the tape and a negligible number lost in the filtrate. Contamination is very small. Application of the system to other cytological material (fine needle aspirations, monolayer and cell suspension cultures, agar cultures, and isolated nuclei) is shown. In general, more than one slide can be made from one sample. Several histological staining procedures as well as immunofluorescence labeling protocols can be applied to the preparations obtained in this way. This system thus introduces a method that will standardize specimen preparation, is quick, saves operator time, and can be used for both diagnostic and research applications.     

Application of malignancy-associated changes of the cervical epithelium in a hierarchic classification concept

For almost 10 years malignancy-associated changes (MAC) have been consistently found by means of high resolution image analysis of apparently normal uterine cervical cells. This study was performed on Feulgen-stained monolayer specimens from 55 healthy women and 19 patients suffering from various stages of cervical neoplasia. About 200 epithelial cells and 30 trout red blood cells in each case were measured by image cytometry at a spatial resolution of 0.27 micron. The philosophy of classification is based on the hierarchic stepwise definition of 'truly normal' specimens by removal of all suspicious specimens, characterized by the presence of atypical cells or subvisually altered cell populations. The suitability of MAC-sensitive classifiers, in combination with classifiers for the recognition of atypical cells, was demonstrated. The demands of automated prescreening were met by several decision tree procedures (95-100% sensitivity, 85-95% specificity). By focussing on the MAC evidence a new risk group from seemingly healthy women may be defined.     

Automated cervical cytology screening: performance requirements and instrument evaluation.

Continuing progress towards automation of cervical cancer screening requires that criteria for clinical acceptability of automated systems be defined, and that methods be devised for effectively evaluating new technology. The potential roles of automation in cervical cancer detection, performance requirements, instrument evaluation and useful contributions from tuberculosis screening, automated white blood cell differential counting, signal detection theory and decision theory are discussed.     

Preparation of methacrylate-embedded cytologic smears from prefixed cells

A new method of preparing smears of alcohol-fixed cytologic material by using methacrylate embedding medium to make the cells adhere on plain glass slides is presented. After centrifugation, the cytologic material was mixed with Lowicryl K4M embedding medium and smeared on slides. The polymerization process was achieved by exposing the slides to ultraviolet light. The morphology in such smears was similar to that of specimens prepared by the filter technique. The methacrylate method does not have the most common disadvantages of the filter technique--the development of air bubbles over time and the visually disturbing presence of the filter.     

Morphologic characteristics of p16INK4a-positive cells in cervical cytology samples

OBJECTIVE: Overexpression of p16INK4a has been proposed as a biomarker helpful for the identification of dysplastic cervical epithelial cells on histologic slides as well as in cervical smears. Since a few nontransformed cells in the genital tract in some instances may also express p16INK4a, we evaluated whether applying established morphologic criteria for cervical dysplasia allows a distinction of dysplastic from nondysplastic p16INK4a-stained cells in cytologic samples. STUDY DESIGN: Liquid-based cytology samples were obtained from a screening population (n=50), and from patients attending a dysplasia clinic (n=40). Slides prepared from these samples were stained with the conventional Papanicolaou stain procedure. From each specimen, a second slide was prepared in parallel and immunostained for p16INK4a. Cytologic diagnoses for most patients attending the dysplasia clinic could be compared to the reported histologic diagnoses on punch biopsy samples taken from the patients at the time of colposcopy. This allowed a comparison of the cytology and p16INK4a immunostaining results with subsequent hematoxylin and eosin-based histologic diagnoses. RESULTS: Overall, in 10% of slides obtained from patients with nonsuspicious smears, few p16INK4a-positive cells were found. Using established morphologic criteria and applying these criteria on cells showing any p16INK4a immunoreactivity, p16INK4a-positive normal or metaplastic cells could be discriminated from p16INK4a-expressing dysplastic cells. In 21 of 22 cases (95%) of high grade lesions (cervical intraepithelial neoplasia 2 or higher in follow-up histology), easily recognizable p16INK4a-positive dysplastic cells could be detected, with the remaining case lacking dysplastic cells in the thin-layer slide used for p16INK4a immunostaining. CONCLUSION: Established morphologic criteria for cervical dysplasia can be readily applied to p16INK4a-immunostained cytologic specimens. Thus, p16INK4a immunostaining may help to avoid ambiguities in the interpretation of cervical cytology samples and facilitate more rapid diagnosis and possibly even automated screening of cytologic slides.     

Rapid Isolation of Metabolically Active Mitochondria from Rat Brain and Subregions Using Percoll Density Gradient Centrifugation

Two procedures are described for isolating free (nonsynaptosomal) mitochondria from rat brain. Both procedures employ a discontinuous Percoll gradient and yield well coupled mitochondria which exhibit high rates of respiratory activity and contain little residual contamination by synaptosomes or myelin. The procedures are considerably more rapid than methods described previously for the isolation of brain mitochondria and do not require an ultracentrifuge or swing-out rotor. The first method separates mitochondria by gradient centrifugation from a P2 (crude mitochondrial) fraction and is likely to be widely applicable for studies in which at least 500 mg of tissue are available as starting material. In the second method, the unfractionated homogenate is subjected directly to gradient centrifugation. This method requires the preparation of more gradients (per gram of tissue) than the first method and yields a subcellular fraction with slightly more synaptosomal contamination. However, this second procedure is more rapid, requires less manipulation of the tissue, and is suitable for obtaining mitochondria with well preserved metabolic characteristics from subregions of single rat brains.     

A simple and inexpensive method for preparing erythrocyte membranes by filtration through a hollow-fiber system

An efficient, simple method for preparing biologically active erythrocyte membranes is described. The semi-automated procedure involves circulating hemolysate mixture through a hollow-fiber system, thereby filtering off intracellular components leaving a high yield of washed ghosts. The prepared ghosts exhibit cation-stimulated ATPase activities comparable to those of ghosts prepared by traditional methods. Electron micrographs revealed that the filtration isolation caused less shearing of the membranes than procedures based solely on centrifugation.     

Construction and use of spotted large-insert clone DNA microarrays for the detection of genomic copy number changes

Microarray-based comparative genomic hybridization has become a widespread method for the analysis of DNA copy number changes across the human genome. Initial methods for microarray construction using large-insert clones required the preparation of DNA from large-scale cultures. This rapidly became an expensive and time-consuming process when expanded to the number of clones needed for higher resolution arrays. To overcome this problem, several PCR-based strategies have been developed to enable array construction from small amounts of cloned DNA. Here, we describe the construction of microarrays composed of human-specific large-insert clones (40-200 kb) using a specific degenerate oligonucleotide PCR strategy. In addition, we also describe array hybridization using manual and automated procedures and methods for array analysis. The technology and protocols described in this article can easily be adapted for other species dependent on the availability of clone libraries. According to our protocols, the procedure will take approximately 3 days from labeling the DNA to scanning the hybridized slides.     

A small-scale method for the isolation of insulin-containing secretory granules from islets of Langerhans

A method has been developed which uses small-scale (400 microliter) Percoll gradients and an inexpensive bench-top microcentrifuge for the rapid isolation of insulin-containing secretory granules from islets of Langerhans available from a single rat pancreas. Granule fractions were prepared from homogenates of isolated rat islets by a differential centrifugation step (10 min) to produce a granule-enriched membrane pellet, followed by a further centrifugation (10 min) on a discontinuous Percoll gradient to produce a granule fraction. Measurement of membrane-marker enzyme activities suggested that the yield and purity of granule fractions prepared by this method were comparable to those reported for other methods involving longer centrifugation times in ultracentrifuges. Further purification of the granule fractions by removing lysosomal contamination was achieved by an additional centrifugation (10 min) on another small-scale gradient of higher Percoll concentration. The method proved useful for isolating biosynthetically labeled secretory granule membranes and contents from islets of Langerhans which had been cultured in the presence of 35S-labeled amino acids. The speed and simplicity of this method suggest that it will prove useful in studies requiring the rapid isolation of insulin-containing secretory granules from isolated islets.     

A new look at cervical cytology. ThinPrep multicenter trial results.

The objective of this study was to compare the sensitivity of a new test method with the smear method for detection of neoplasia of the uterine cervix. The new procedure, the ThinPrep process, is an automated, fluid-based technique for the collection and preparation of exfoliated and aspirated cytologic specimens. A single sample from each patient was split and prepared both with the smear and test methods. The diagnostic results from the two slides were compared in this blind study. Among a total of 2,655 patients, diagnoses concurred in 92% of cases and were within one diagnostic level of each other 98% of the time. The ThinPrep method facilitated the detection of more low-grade lesions (P less than .001, McNemar's test). In addition, the test method decreased the number of ambiguous interpretations. The ThinPrep method appears to improve the cervical cytologic smear quality by the harvest of a random and reproducible sample, with a reduction in artifacts. The new method improves the sensitivity of the cervical cytologic screening test.     

Comparison of TriPath thin-layer technology with conventional methods on nongynecologic specimens

OBJECTIVE: To evaluate the use of the TriPath PREP (previously called AutoCyte) TriPath Inc., Burlington, North Carolina, U.S.A.) in nongynecologic cytologic material by performing side-by-side comparison of conventional preparations with TriPath-prepared slides. STUDY DESIGN: An initial study of 613 cases (set A) was conducted to compare the TriPath PREP system with conventional methods for the evaluation of nongynecologic specimens, including urine, body cavity effusions, cerebrospinal fluid, pulmonary and gastrointestinal specimens. Paired cases were evaluated for cellularity, staining quality, preservation and representation of diagnostic material. Subsequent changes in the automated technique warranted reevaluation of the TriPath method. The follow-up study of 259 cases (set B) was conducted with the same design as set A. Results of evaluated parameters were analyzed using the chi 2 test. RESULTS: Results of the two sets were strikingly different. Prior to technical changes made by the laboratory, the TriPath method was significantly inferior. In the second set, the preferred material was most commonly the TriPath-prepared material. In particular, the majority of urine samples were prepared better by the automated, thin-layer system. CONCLUSION: The TriPath PREP system offers a reliable preparation of urine and has potential for other nongynecologic specimens, provided that careful attention is paid to technical details and some adjustments are made to account for specimen variability.     

Preparatory methods for DNA hydrolysis, cytochemistry, immunocytochemistry and ploidy analysis. Their application to automated and routine diagnostic cytopathology

A review is presented of some methods used to prepare cytologic specimens for analytical and/or automated studies, with the steps of the procedures detailed in appendices. The preparation of the cell monolayers required for optimal automated cell image analysis and classification, e.g., by the Cytoscan 110, is discussed, as is the preparation of poly-L-lysine-coated slides used in the production of monolayered specimens. These monolayers, which can be prepared from a variety of specimens, are also useful for cytochemical and immunocytochemical studies and DNA ploidy analysis. For DNA analysis, a modified gallocyanin chrome alum staining procedure is described as a stoichiometric alternative to the time-consuming Feulgen reaction. The hydrolysis technique required by the latter method is also detailed. The freeze-fracturing technique for the enhancement of monoclonal antibody immunocytochemical staining of detectable antigens is described, along with an indirect immunoalkaline phosphatase staining method. The use of enzyme cytochemical reactions for glucose 6 phosphate dehydrogenase and lysosomal naphthylamidase is also presented.     

Isolation of skeletal muscle nuclei

A method for isolation of nuclei from rat skeletal muscle is described. The tissue is homogenized in the presence of Triton X-100, resulting in release of the nuclei from the muscle fibers. A crude nuclear pellet is prepared by differential centrifugation, and further purification is accomplished by centrifugation through dense sucrose. Bovine serum albumin is used to stabilize the nuclei during the isolation procedure. The isolated nuclei have been characterized microscopically and by chemical and enzymatic assay procedures.     

Isolation of Undegraded Free and Membrane-Bound Polysomal mRNA from Rat Brain

A new procedure is described for the isolation of undegraded free and membrane-bound polysomal mRNA from rat brain in which polysomes are simultaneously separated from soluble components of the cell and slowly sedimenting ribosome species and concentrated by rate-zonal centrifugation on short linear sucrose gradients. This avoids the problem encountered in conventional procedures of pelleting polysomes along with membranous materials that are not solubilized by detergents and that appear to contain traces of nucleases. It also permits a more thorough analysis of the mRNA populations actively engaged in protein synthesis, since both polyadenylated and nonpolyadenylated mRNAs are isolated together. Moreover, the likelihood of sedimenting nonpolysomal mRNP particles along with polysomes is reduced by using rate-zonal rather than pelleting centrifugation. The translational activity in vitro of free and membrane-bound polysomal RNA prepared in this way is high and is about 1.5 times that of RNA prepared by a conventional pelleting technique. The difference is attributable to better preservation of large mRNAs, as inferred from two-dimensional gel electrophoretic analysis of translation product abundance. The recovery of both classes of polysomal RNA is about 90%. The method is simple, efficient, and adapted for isolation of small amounts of polysomal RNA.     

Technical External Quality Assessment for SurePath® stained liquid-based cytology gynaecological cervical samples using control material – a novel approach

Aims and objective: The Technical External Quality Assessment Scheme (TEQA) introduced in Wales is based on NHSCSP publication No 19 [External Quality Assessment Scheme for the Evaluation of Papanicolaou Staining in Cervical Cytology] which sets out the policies and standard operating procedures for the TEQA of Papanicolaou staining of gynaecological cervical samples. As part of a development plan for the TEQA scheme in Wales, the use of a control sample was introduced to the assessment process – a common control sample can provide a consistent assessment parameter independent of the recommended slide selection process [External Quality Assessment Scheme for the Evaluation of Papanicolaou Staining in Cervical Cytology, NHSCSP Publication No 19, February 2004] enabling direct comparison of staining standards for laboratories within the region; this counters selection variation bias, establishing a process that may be more representative of routine staining results. Methods: A cervical sample was selected in line with the criteria described in publication 19 [External Quality Assessment Scheme for the Evaluation of Papanicolaou Staining in Cervical Cytology, NHSCSP Publication No 19, February 2004]. Thirteen slides were prepared by the scheme facilitator from this anonymized sample. These control slides were subsequently ‘fixed’ but not stained, then distributed to the laboratories participating in the TEQA scheme. The slides were stained using their standard regime, then returned to the facilitator for assessment. The slides showed consistent staining with no significant inter‐laboratory variation, however, the eosinophilic stained components exhibited an artificial colouration, which slightly altered the expected stained appearance; this was thought to be due to ‘cross‐reactivity’ of the spray fixative with the preserving agent. To address this artefact, a further development of control procedures was devised utilizing a pooled control sample procedure. Residual material from a number of similar samples was pooled and distributed in aliquots to participant laboratories for standard processing and staining; the completed slides were returned to the scheme facilitator for assessment. Results: The pooled sample slides were assessed at the next scheduled quarterly TEQA assessment. The overall scoring for these samples produced an acceptable level of Papanicolaou staining for 12 of the laboratories – only one laboratory produced a marginal score. The artefactual presentation of eosinophilia was not seen. Discussion/conclusion: This method of producing control material establishes consistency in the TEQA comparative assessment process, counters selection bias and reduces the time demands associated with slide selection. It may also prove useful in identifying technical problems within laboratories during sample preparation prior to or during staining, including equipment or process faults. This technique is now well established locally as an enhancement of the current TEQA scheme for the assessment of slide staining. We feel that this enhancement could be incorporated as a new initiative in the current National TEQA scheme as a complement to the established selection process.     

Evaluation of contextual analysis for computer classification of cervical smears

A procedure for automated analysis of cervical smears has been implemented in an image cytometry system. Smears are described exclusively in terms of global and contextual information extracted by pattern-recognition algorithms and represented by a vector of proportions of cellular object types. Linear discriminant functions, based on a Fisher criterion, are derived to classify smears with a cross-section of diagnoses into two broad categories, normal and abnormal. Results obtained from 83 smears indicate 78% correct classification. In contrast to most automated systems, good classification results were obtained in normal smears with benign changes caused by inflammation and with postmenopausal atrophia and in abnormals with mild dysplasia. These findings suggest that contextual analysis may be sensitive to subtle changes in cellular morphology and to progressive patterns of dysplasia. When used with standard isolated cell analysis, contextual analysis may provide additional complementary information for automated cervical prescreening.     

Robust automated tumour segmentation on histological and immunohistochemical tissue images

Tissue microarray (TMA) is a high throughput analysis tool to identify new diagnostic and prognostic markers in human cancers. However, standard automated method in tumour detection on both routine histochemical and immunohistochemistry (IHC) images is under developed. This paper presents a robust automated tumour cell segmentation model which can be applied to both routine histochemical tissue slides and IHC slides and deal with finer pixel-based segmentation in comparison with blob or area based segmentation by existing approaches. The presented technique greatly improves the process of TMA construction and plays an important role in automated IHC quantification in biomarker analysis where excluding stroma areas is critical. With the finest pixel-based evaluation (instead of area-based or object-based), the experimental results show that the proposed method is able to achieve 80% accuracy and 78% accuracy in two different types of pathological virtual slides, i.e., routine histochemical H&E and IHC images, respectively. The presented technique greatly reduces labor-intensive workloads for pathologists and highly speeds up the process of TMA construction and provides a possibility for fully automated IHC quantification.     

Components and results of a new preparation technique for automated analysis of cervical samples

Components and evaluations of a new preparative procedure for automated high-resolution analysis of cervical samples are presented. This procedure is based on sedimentation velocity separation of samples with subsequent fractionation of the separation column and centrifugal deposition of suspended cells on coated glass slides. A system for specimen collection and mailing of suspended samples is described. A new type of glass slide designed for automated analysis is presented, and centrifugal buckets for cell deposition on a 6-sq-cm area are described. Experimental results with different kinds of coating substances for glass slides as well as different isopyknic media are discussed, and data for differential cell counts are graphically demonstrated. Looking at the diagnostic accuracy and economic feasibility of this system, the authors realize that preparations have to be evaluated quantitatively and that constraints of sample size and processing time have to be taken into consideration for further developments.